Provider Demographics
NPI:1194819532
Name:NORTH COUNTY TRAUMA SERVICES, INC.
Entity Type:Organization
Organization Name:NORTH COUNTY TRAUMA SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INCORPORATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:CUEVAS
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-433-8844
Mailing Address - Street 1:451 MARCH AVENUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3387
Mailing Address - Country:US
Mailing Address - Phone:707-433-8844
Mailing Address - Fax:707-433-8836
Practice Address - Street 1:451 MARCH AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3387
Practice Address - Country:US
Practice Address - Phone:707-433-8844
Practice Address - Fax:707-433-8836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA687212086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma SurgeryGroup - Single Specialty